FOAMcast - Emergency Medicine Core Content

This week we review Dr. Josh Farkas's PulmCrit blog posts, Renal microvascular hemodynamics in sepsis: a new paradigm and Renoresuscitation: Sepsis resuscitation designed to avoid long-term complications in which he posits that renal protection in sepsis may prove beneficial for patients.  

Then, we delve into core content pearls on acute kidney injury using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide) as a guide.  

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_21._Acute_Renal_Failure.mp3
Category:general -- posted at: 10:24pm EDT

This week we review Dr. Rory Spiegel's EMNerd blog post, A Case of Identity Part Two, on dual antiplatelet therapy for ACS and MI. 

  • Dual antiplatelet therapy, often aspirin + P2Y12 inhibitors, although commonly used, do not affect mortality and have questionable benefit but are associated with risks of bleeding.

Then, we delve into core content pearls on anticoagulation including aspirin, ibuprofen, and novel oral anticoagulants using Rosenalli  (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide) and Goldrank (10th ed) Chapter 60 and EMPractice October 2013 as a guide.  

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer


This week we review the Tox Talk podcast, Episode 23, Mushrooms. Key pearls 

Clitocybe, Inocybe - contain muscarine which stimulates muscarinic receptors (acetylcholine/parasympathetic), causing a cholinergic toxidrome. 

  • Memory aid: these mushrooms end in -yBE, akin to the "killer B's" that make cholinergic toxicity deadly - bradycardia, bronchorrhea, bronchospasm.

Gyromitra - (false morel)

  • Memory aid: gyromitra named because they look like the gyri of the brain and, conveniently, make the brain seize through depletion of GABA. 

Amanita phalloides - the mushroom equivalent of acetaminophen toxicity.

Then, we delve into core content pearls on accidental hypothermia using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).  

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer


This week we review Dr.Ken Milne's podcast, the Skeptics Guide to Emergency Medicine new feature - Hot off the Press. It's all about geriatric falls, y'all.

Then, we delve into core content pearls on the geriatrics using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).  We review polypharmacy, abdominal pain, and other key pearls.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_18_Falls_and_Geriatrics.mp3
Category:general -- posted at: 12:28am EDT

FOAMcast will be back shortly with regular core content-cutting edge mash ups; however, we wanted to take a moment to focus on a conference that inadvertently created FOAMcast...and is coming to Chicago in June 2015.

 SMACC - Chicago (#smaccUS) June 23-26, 2015. Registration begins Nov 5, 2014

There are too many core content lectures to choose from and they're available on iTunes.

Our favorites are listed on FOAMcast.org and here we review:

Dr. Haney Mallemat - The Art and Science of Fluid Responsiveness

Dr. Scott Weingart - Sepsis in New York: Our First 15,000 Patients

Dr. Cliff Reid - Resuscitation Dogmalysis

Dr. Rob Mac Sweeney - ARDS: An Evidence Based Update

Timing, Tribes, and STEMIs

 

Direct download: FOAMcastini_-_SMACC.mp3
Category:conferences, FOAM, smacc -- posted at: 9:23pm EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  

Today's Pearls:

ACEP is revisiting the TPA policy - Dr. David Newman, Dr. Edward Sloan, and Dr. Seaberg

Evidence based approach to Intracerebral Hemorrhage by Dr. Jon Edlow

Drs. Jerome Hoffman and Richard Bukata delivered key literature pearls.

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Wednesday.mp3
Category:general -- posted at: 8:03pm EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  

Today's Pearls:

HIV patients are at risk for ACS and thrombotic complications

Resuscitation pearls from Weingart:  Don't trust "normal" vital signs, ACLS is not for emergency physicians, REBOA and ECMO are coming

Palliative care in the Emergendy Department - important and often not well done

ACEP has 5 more "Chosing Wisely" Pearls

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Tuesday_.mp3
Category:general -- posted at: 5:47pm EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  

Today's Pearls:

Emergency Physicians are like economists (We're more probalisticians than diagnosticians).

Cardiology pearls from Dr. Slovis - TTM to 36 Celsius post-arrest should be standard. Many people probably could benefit from caths after arrest, we're not sure exactly who at this point.

Patients returning from West Africa with fever probably have a regular virus, maybe malaria, but probably not ebola.

There's really not much use for glucagon in calcium channel blocker toxicity. Think supportive care, insulin-dextrose.

ETCO2 - it doesn't equal PaCO2 and it depends on cardiac output and alveolar ventilation  

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Monday_.mp3
Category:general -- posted at: 6:59pm EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  However, Jeremy and I both worked overnights so we got into town a little late.  Our friends and ACEP luminaries, Drs. Justin Hensley, Howie Mell, and Todd Slesinger.

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Sunday_Day_1.mp3
Category:general -- posted at: 10:21pm EDT

This week we review Dr. Scott Weingart's EMcrit episode, The First Prehospital REBOA

Then, we delve into core content pearls on the spleen using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).  We cover splenic trauma and lacerations, post-splenectomy sepsis, and splenic sequestration.

Key Texts: Rosen's Chapter 46, 134 and Tintinalli Chapter 260.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_17a._Reboa_and_SPLEEN_fix.mp3
Category:trauma, spleen -- posted at: 10:06am EDT

This week we review Dr. Rob Orman's ERCast episode, Is it really a sinus headache?

Then, we delve into core content headache pearls with an ophthalmology bent using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).  We cover temporal arteritis, acute angle closure glaucoma, idiopathic intracranial hypertension, and cerebral venous sinus thrombosis.

Key Texts: Tintinalli (7e): Ch 159; Rosen's (8e) Ch 20, 103

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_16._ERCAST_and_Headaches.mp3
Category:neurology -- posted at: 3:56pm EDT

In this tiny episode, Jeremy gives his bottom line pearls for FOAMcast episodes 4-14.  You know, because spaced repetition is a good thing.  We've got anaphylaxis, heart failure, ebola, acid-base, and more.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_3._Episode_4_to_14_Pearls.mp3
Category:general -- posted at: 9:18pm EDT

This week we review a post by Brent Reed on Academic Life in EM, covering pharmacologic management of atrial fibrillation.  

Then, we delve into core content Emergency Medicine cardiology using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).  We cover atrial fibrillation, atrial flutter, and, everyone's favorite, multifocal atrial tachycardia.

Key Texts: Tintinalli (7e): Ch ; Rosen's (8e) Ch 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Direct download: FOAMcast_Episode_15._Afib_flutter_MAT_.mp3
Category:cardiology -- posted at: 3:22am EDT

This week we review EM in 5's episode on the hand neuro exam.

Then, we delve into core content hand pearls including flexor tenosynovitis, extensor tendon injuries, amputations, and more using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).

Key Texts: Tintinalli (7e): Ch 280, 295; Rosen's (8e) Ch 50

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Direct download: FOAMcast_Episode_14._Hand_neuro_revised.mp3
Category:general -- posted at: 12:16am EDT

This week we review Right Axis Deviation from Dr. Amal Mattu's ECG Video of the Week - Why You Should Care When Things are Totally RAD as well as EMCrit Episode 98 on TCA Overdose treatment

Then, we delve into core content toxicology pearls regarding tricyclic antidepressants and sodium channel blockade using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide) in addition to Goldfrank's Toxicology

Key Texts: Tintinalli (7e): Ch 171; Rosen's (8e) Ch 151 Goldfrank Ch 73 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Direct download: FOAMcast_Episode_13_RAD_and_TCA_overdose.mp3
Category:toxicology -- posted at: 12:00pm EDT

This week we review Dr. Salim Rezaie's REBEL Cast Episode 1 on Biphasic Anaphylaxis

Then, we delve into core content allergy/immunology pearls on Anaphylaxis and Angioedema using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide)

Key Texts: Tintinalli (7e): Ch 27; Rosen's (8e) Ch 119

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_12_anaphylaxis.mp3
Category:allergy -- posted at: 1:56pm EDT

This week we review Mount Sinai Emergency Medicine Residency's blog post on Ebola.

Then, we delve into core content infectious disease pearls on Airborne and Droplet isolation and infectious agents such as varicella using Tintinalli as our predominant reference.

Key Texts: Tintinalli (7e): Ch 148, Ch 157; The CDC

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_11_Ebola.mp3
Category:infectious disease -- posted at: 11:20am EDT

This week we review Dr. Natalie May's brilliant post on the St. Emlyn's blog, "When Sick Means Sick: Emesemantics and Vomiting in Kids"  in which she dissects emesis descriptors such as bilious, projectile, and coffee-ground.

Then, we delve into core content on Neonatal Jaundice and Intussusception.

Key Texts: Tintinalli (7e) Chapters 111, 124 ; Rosen's (8e) Chapter 172

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_10_Peds_vomiting.mp3
Category:general -- posted at: 6:26pm EDT

 

In this episode we review Dr. Scott Weingart's Practical Evidence Podcast #3 on Management of First Trimester Vaginal Bleeding and ACEP's 2012 Clinical Policy.  After a thrilling discussion of the discriminatory zone and ultrasound, we digress into core content covering bleeding in later pregnancy (placental abruption and previa), abdominal pain in pregnancy including septic abortion and chorioamnionitis, as well as eclampsia and pre-eclampsia.

Key Texts: Tintinalli (7e) Chapters 102-105 ; Rosen's (8e) Chapter 178

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_9_Pregnancy_072614.0802.mp3
Category:pregnancy -- posted at: 6:30am EDT

This tiny episode covers Hypernatremia - a supplement to our Episode 8 on acid-base and hyponatremia.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Key Texts: Tintinalli (7e) Chapters 19,21 ; Rosen's (8e) Chapters 124, 125

Thanks y'all!

 

-Jeremy Faust and Lauren Westafer

Direct download: FOAMCASTini_2_hypernatremia.mp3
Category:electrolytes -- posted at: 8:29am EDT

We review the FOAM from SMACC GOLD, Dr. David Story's "Is Chloride A Poison?" for a great primer on the Stewart method to acid-base.  The Strong Ion Difference (SID) is essentially Sodium minus Chloride (Na - Cl). Normal = 38; a higher SID indicates metabolic alkalosis and a lower SID indicates a metabolic acidosis.  "Normal Saline" has a whopping amount of chloride, which decreases the SID and has been associated with acidosis, renal insufficiency in critically ill patients, and, perhaps, mortality.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Key Texts: Tintinalli (7e) Chapters 19,21 ; Rosen's (8e) Chapters 124, 125

FOAM Resources: Acid-Base ala EMCrit I/II/III/IVHyponatremia - EMBasic, Hyponatremia-ERCastHyponatremia - EMCrit

Thanks y'all!

-Jeremy Faust and Lauren Westafer

 

 

 

Direct download: FOAMcast_Episode_8._Smacc-ICN_Chlorine._071714.1032.mp3
Category:acid-base -- posted at: 12:03pm EDT

On this FOAMcastini (A tiny FOAMcast), we summarize our summaries of core content and free open access medical education (FOAM), covering:

Episode 1 - Cyanide and Carbon Monoxide Toxicity

Episode 2 - All things GU (Renal colic, urinary retention, infected stones)

Episode 3 - ENT (Bullous myringitis, ruptured tympanic membranes, auricular hematomas, and more).

This is our attempt at remembering these things ourselves and encouraging some spaced repetition. Thanks for listening and just remember, no need to FOAM it alone.

-Jeremy Faust and Lauren Westafer

Direct download: Foamcastini_1_ep._1_to_3.mp3
Category:general -- posted at: 7:00am EDT

We review the FOAM from The RAGE podcast (The Resuscitationist's Awesome Guide to Everything), "Episode 4" ,on impact apnea, the right heart and more.  Then we discuss the core content related to right ventricular myocardial infarctions and heart failure.

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts:  Tintinalli (7e) Chapters 53, 57; Rosen’s (8e) Chapters 78, 81

Thanks for listening!

 

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_7._RAGE_Heart_Failure.mp3
Category:general -- posted at: 7:46am EDT

Episode 6 - Hepatic Emergencies

This episode is inspired by a tweet from Dr. Nick Genes who queried why there wasn't more focus on hepatic emergencies in FOAM  (Free Open Access Medical education).  

We review the FOAM from Maryland's Critical Care Project ,"Chyle- coming to a paracentesis near you," on chylous ascites.  Then, we discuss core content liver emergencies, focusing on Spontaneous Bacterial Peritonitis, Hepatic Encephalopathy, and a smattering of hepatotoxic drugs.

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts: Tintinalli's Emergency Medicine: A Comprehensive Board Review(7e) Chapter83, Rosen’s Emergency Medicine (8e) Chapter 90

Thanks for listening!

-Jeremy Faust and Lauren Westafer


We review the FOAM (Free Open Access Medical education) from Academic Life in Emergency Medicine, "Atypical Antispychotic Medication Re-initiation in the Emergency Department" and Dr. Casey Parker's Broome Docs Podcast "Optic Nerve Sheath Diameter."  Then, we discuss core content emergencies including a review of select psychiatric disorders and management of increased ICP.

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts:

  • Tintinalli's Emergency Medicine: A Comprehensive Board Review(7e) Chapters 284, 254
  • Rosen’s Emergency Medicine (8e) Chapters 110, 29 

Thanks for listening!

 

-Jeremy Faust and Lauren Westafer


We review the FOAM (Free Open Access Medical education) from Dr. Ryan Radecki's Emergency Medicine Literature of Note, "Infections & Transfusions" and "Grilling Injuries on Memorial Day."  Then, we discuss core content emergencies including transfusion reactions and ingested foreign bodies.

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts:

  • Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7e) Chapter 233
  • Rosen's Emergency Medicine(8e) Chapter 7

Thanks for listening!

 

-Jeremy Faust and Lauren Westafer


Episode 3 - SMART EM and Ear Emergencies

We review FOAM (Free Open Access Medical education), SMART EM "Pseudoaxioms 2 and Literature Update," in which Dr. David Newman discussesthe lack of benefit for tamsulosin in most renal colic.  Then, we discuss core content urologic emergencies including:

  • Bullous Myringitis
  • Perforated Tympanic Membrane
  • Auricular Hematoma
  • Necrotizing Otitis Externa (Malignant Otitis Externa)

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts:

Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7e) Chapter 237

Rosen's Emergency Medicine(8e) Chapter 92

Thanks for listening!

 

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_3._SMART_EM_Bullous_Myringitis_060114.1401.mp3
Category:general -- posted at: 7:00am EDT

Episode #2:  Urologic Emergencies

We review FOAM (Free Open Access Medical education), The Skeptic's Guide to Emergency Medicine Episode #71, in which Dr. Milne discussesthe lack of benefit for tamsulosin in most renal colic.  Then, we discuss core content urologic emergencies including:

  • Renal Colic
  • Infected kidney stones
  • Acute Urinary Retention

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts:

Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7e) Chapters 95, 97

Rosen's Emergency Medicine(8e) Chapter 99

Thanks for listening!

 

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_2._Renal_Colic_SGEM71.mp3
Category:medicine, urology, emergency medicine -- posted at: 7:00am EDT

Episode #1: Cyanide and Carbon Monoxide Toxicity

We review EMCrit Episode #122 in which Drs. Weingart and Nelson review a case of cyanide poisoning in a patient presenting in PEA arrest after a house fire.

 

Show notes and Rosh Review questions at foamcast.org

Key Texts:

Cyanide: Tintinalli (7e) Ch 198; Rosen's (8e) Ch 159

Carbon Monoxide: Tintinalli (7e) Ch 217; Rosen's (8e) Ch 159


1